HOLYOKE (CBS) – The former U.S. Attorney chosen to investigate the coronavirus outbreak at the Holyoke Soldiers Home testified before state lawmakers on Friday.

Last year, Governor Charlie Baker chose former U.S. Attorney Mark Pearlstein to do an independent review of the deadly outbreak at the home. Pearlstein called the decisions made during the outbreak “utterly baffling,” adding there was a void of leadership at the home.

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The state-run facility had one of the deadliest outbreaks at a long-term care facility in the country with 76 residents dying from COVID-19 and dozens of other residents and staffers sickened.

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“We found that the leadership made a catastrophic decision by combining two lockdown dementia units on March 27,” Pearlstein said. “This resulted in severe overcrowding and truly chaotic and ultimately, we believe, ineffective care.”

A special committee of lawmakers has until the end of the month to submit findings and any recommendations for legislation.

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The former superintendent of the Holyoke Soldiers’ Home, Bennett Walsh, and its former medical director David Clinton have been indicted on multiple charges related the coronavirus deaths of veterans at the facility.

CBSBoston.com Staff